Pathology, Molecular Genetics, and Epigenetics of Diffuse Intrinsic Pontine Glioma.

Pathology, Molecular Genetics, and Epigenetics of Diffuse Intrinsic Pontine Glioma.
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DOI:
10.3389/fonc.2015.00147
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发表时间:
2015
影响因子:
4.7
通讯作者:
Hawkins C
Hawkins C
中科院分区:
医学3区
文献类型:
--
作者:
Buczkowicz P;Hawkins C

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弥漫性内在脑桥胶质瘤(DIPG)是一种毁灭性的儿童脑癌,目前尚无有效的治疗方法。DIPG与成人幕上高级别星形细胞瘤的组织学相似性导致假设这些实体具有相似的潜在分子特性,因此对标准疗法具有相似的治疗反应。在过去30年中,所有改善DIPG患者结局的临床试验均失败,这表明并非如此。最近采用下一代测序和微阵列技术的研究提供了广泛的证据,突出了这种癌症独特的分子遗传学和表观遗传学,将其与成人和儿童脑高级别星形细胞瘤区分开来。本文综述了DIPG在分子亚组和组织病理学诊断背景下最常见的分子遗传学和表观遗传学特征,包括这种肿瘤实体独特的突变景观,拷贝数改变和结构变异,以及全球DNA和组蛋白水平上的表观遗传学变化。DIPG生物学和组织病理学知识的增加为新的诊断和治疗途径打开了大门。
Diffuse intrinsic pontine glioma (DIPG) is a devastating pediatric brain cancer with no effective therapy. Histological similarity of DIPG to supratentorial high-grade astrocytomas of adults has led to assumptions that these entities possess similar underlying molecular properties and therefore similar therapeutic responses to standard therapies. The failure of all clinical trials in the last 30 years to improve DIPG patient outcome has suggested otherwise. Recent studies employing next-generation sequencing and microarray technologies have provided a breadth of evidence highlighting the unique molecular genetics and epigenetics of this cancer, distinguishing it from both adult and pediatric cerebral high-grade astrocytomas. This review describes the most common molecular genetic and epigenetic signatures of DIPG in the context of molecular subgroups and histopathological diagnosis, including this tumor entity’s unique mutational landscape, copy number alterations, and structural variants, as well as epigenetic changes on the global DNA and histone levels. The increased knowledge of DIPG biology and histopathology has opened doors to new diagnostic and therapeutic avenues.
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